Wednesday, October 8, 2008

Funds for Nursing Available in Pennsylvania

For those resident of Pennsylvania looking for financial support to go to nursing school, help is out there. The Pennsylvania Higher Education Foundation provides financial aid by way of grants and scholarships for those looking to pursue a nursing career, both at the undergraduate and graduate level.

The PHEF has shown the dedication to assist in strengthening the nursing industry by offering a path to get your nursing degree. With student loans become even more difficult to attain, this program has become infinitely more valuable to assist in a profession that is in desperate need of nurses and nurse educators.

To find out more information on what types of financial aid programs are available to you, visit

Monday, September 29, 2008

A Tribute To Nursing

By Linda S. Smith, MS, DSN, RN, CLNC
Professor and Nursing Program Director, Idaho State University

To venture the task of discussing the great people and events that have made American nursing the powerful profession it is today, is to undertake an impossible task. I do firmly believe, however, that a taste of history is somewhat like eating one Idaho potato chip - it will stimulate and support a lifelong interest in the subject.

We in nursing are fortunate indeed to be able to emulate the leadership and political savvy of Florence Nightingale. She, more than any nurse before or since, shaped and expanded quality health care throughout the British Empire and world. Most people, however, think of Florence Nightingale only as the founder of nursing education. Though this is true, her contributions exceed far beyond nursing and into the realm of illness prevention, health promotion, and community health and safety.

Florence Nightingale (born 1820) was better educated than most men of her day. She was an accomplished linguist, mathematician, statistician, philosopher, and historian. She understood that contrary to the belief of the day, forward thinking people could alter their destiny. She had an insatiable curiosity and a probing, analytical mind. But her greatest handicap by far was being a woman.

Despite this handicap, Nightingale created and developed a system of education affording women a respectable profession. Additionally, she used her strong political powers to enact hospital and military reform. She reformed health care for the British Empire, including India. Nightingale presented rationale for her decisions and needs with expert mathematical skill. She used the power of the press and her own outstanding prolific writing abilities to keep public health issues in full view of the people.

Nightingale was a national heroine and she used this popularity, along with her expert health care and political knowledge, to influence major leaders, including the queen of England.

US Nursing

In the early 1900s, American women did not have the right to vote nor were they allowed political status. Though nursing was almost exclusively female, nurses as a group were enormously conservative in their approach to the women's movement. In 1907, at the 10th annual convention of the Nurse's Associated Alumnae of the US (now known as the American Nurses Association), the question of women's suffrage (right to vote) was hotly debated and a resolution in support of the women's movement defeated.

Nurse Lavinia L. Dock, however, stands out as one of the strongest, most pro-feminist American nurse of all time. She marched in Washington and went to jail for her belief in equal rights for women. When, in 1920, congress passed the 19th amendment to the constitution giving women voting rights, Dock continued her equal rights crusade in opposition to countless other discriminations against women. Her basic premise, until she died, was that all people are equal.

The power of the press was the motto and mission of Nurse Sophia Palmer, first Editor and Publisher of the American Journal of Nursing. Palmer had great insight into the need for nurses to control their own profession. Her editorials helped create the first American nursing licensing laws and boards in 1903. Palmer took risks and made a major difference for us all. Because of her and others, boards of nursing govern American nurses and American nurses have legal standards for practice and education. These standards forbid unqualified, unlicensed persons from calling themselves registered nurses or RNs.

This is an exciting time to be a nurse! Because of increasing population census, a growing number of elders, expanded technology, health care reform, and emerging nursing roles, many new nursing jobs in Idaho will surface. These new jobs will require well-educated, dedicated, competent, caring, decision-makers and client advocates. Nationally, the healthcare system will require more than 1.2 million new nurses over the next decade. That means that the second largest number of new jobs among all occupations will be for RNs.

RNs work to promote health, prevent disease, and help patients and families cope with illness and disability. They are advocates and health educators for patients, families, communities. RNs develop and manage patient treatment plans; instruct patients and families in proper care; and help individuals and groups take steps to improve or maintain health and quality of life.

Though there will always be a need for hospital nurses, in the future, a growing number of nurses will be employed in home health, long-term care, hospice, parish nursing, prison care, community care, surgical centers, and ambulatory clinics.

This week, please stop for a moment to thank a nurse who has helped you or someone you love find health, wellness, strength, and an improved quality of life. Individuals, families, communities, organizations, specialties, and health services have discovered the importance of quality nursing. Florence Nightingale, we are proud to be walking in your nursing shoes.

Thursday, September 18, 2008

Why Does She Stay?

Why does she stay?

*Female victims of domestic and partner violence


Linda S. Smith, MS, DSN, RN, CLNC

Professor and Director, Associate Degree Registered Nurse Program,
Idaho State University

"Husband suspect in city killing. Police say a 25-year-old man is suspected in the death of his 26-year-old wife who was bludgeoned (in the head) to death. The man is scheduled to appear in court this morning and police said they would seek first degree murder charges."

Homicide is one complication of domestic and partner violence. Other complications are the more than two million abused women* each year seeking medical help for injuries. She may be stabbed, kicked, pushed into fires, thrown through glass, or downstairs, strangulated (called throttling), and raped.
Results of these violent crimes are seen everywhere -- in clinics, hospitals, schools, churches, community centers, and psychiatric departments. Healthcare professionals see the results and the complex costs for persons, families, and communities. Sadly, ever more cases of abuse are surfacing.
Battered women are found in all socio-economic groups and all education levels. They are partners of postal clerks, physicians, ministers, construction workers, policemen, bankers, and mechanics. It may be hard for friends and associates to believe he* could be doing the things she describes.
Jane Doe is an example. “Jane” was admitted to the orthopedic unit of a hospital having suffered compression fractures of the lumbar spine after jumping out of a second story window. When Jane’s husband beat her with everything he could find, Jane jumped to escape his attack.

Why does she stay?

Importantly, abused women often wish to see an end to the abuse but not necessarily an end to the relationship. Therefore, the question, "Why does she stay?" is complex. Often perpetrators have isolated female victims from friends, family, employment, money, and education. Abusers may become pathologically enraged.

One of the most dangerous times for her is when the perpetrator knows or suspects that the woman is going to leave. He will perceive her leaving as his own loss of control – that is often when the lethality of the abuse escalates. The average woman will try to leave seven times before she effectively separates from the violent perpetrator. But each time she returns, she puts herself in great danger. Perpetrators will do whatever it takes to keep their victims from leaving.

Victim and perpetrator often have grown up in an atmosphere of abuse -- learning violence first hand. This “training” may contribute to the woman's feelings of low self esteem and acceptance of abuse as a way of life. Abuse is compounded by a lack of resources and the woman's own feelings of responsibility for holding family and relationship together. Fear and intimidation increase by threats such as, "I'll kill you and the kids if you don't do as I say." “If you try to leave, I’ll find you and kill you.” “You are too stupid and ugly to be able to do anything on your own.” Alcohol and other drugs may give perpetrators yet another excuse for unacceptable behavior. Also, victims may turn to alcohol or drugs in attempts to medicate their mental and physical pain.

Helping the female victim

Abused women may not be able to remove themselves from a domestic or partner violence situation without help and support; victimized women may return to the abuse because they can’t find resources to sustain their leaving.

Five common behaviors used by perpetrators:
1. Physical abuse such as kicking, hitting, strangling, using a weapon;

2. Sexual abuse such as forced sexual activity

3. Psychological abuse such as threatening/humiliating the victim by saying "I'll take the kids," or "I'll kill myself;” name calling; forcing the victim to perform humiliating acts

4. Isolation such as preventing victims from seeing or talking to certain people such as shelter advocates, family, or friends; monitoring mail, phone calls, mileage, and daily activities; slashing tires or keeping victims from transportation, employment, education

5. Intimidation: such as physically intimidating without actually causing bodily harm; injuring or killing pets; destroying prized possessions

If allowed to continue, violence often escalates.

Support from the entire community is essential.

All persons have the right to physical and psychological safety. Unfortunately, assault behavior is occurring everywhere. If you or someone you love is experiencing violence, please get the needed help. For more information, contact the National Domestic Violence Hot line at or calling 1-800-799-SAFE but if you fear retaliation, do not use your home computer; access this link on a “safe” computer system such as at your local library or school.

*Though this article focuses on female victims of partner violence, the author recognizes that women may be perpetrators as well as victims and men and boys are also victims.

Tuesday, September 9, 2008

Helping Someone Who Grieves


Linda S. Smith, MS, DSN, RN, CLNC
Professor and Director of the Associate Degree Registered Nurse Program
Idaho State University

Grief, loss, anger, despair, and guilt are human responses to any tragedy. They are normal, yet entirely unique, because each of us resolves grief and loss in our own way.
Accepting loss and even death is probably the hardest part about being human. When a friend or loved one is grieving, we may be afraid to get involved; to talk about the loss or death; to feel it for and with someone. We may say, "I hate going over there to visit, it's so depressing;" or "Why should I call or stop over; I can't do anything to make it better."
Yet, moods and reactions people have as they grieve a significant loss are often responses to how others react toward them and what others expect. With this in mind, it is easy to see how people "pick up" on the obvious and hidden "expected behaviors" from the persons who are closest to them. Therefore, if someone you know and love is experiencing grief, your reactions and responses to them can improve or worsen the situation.

First, friends and loved ones need to understand the fears of those who grieve. These fears include loneliness, meaninglessness, and continued loss. Families of persons who are dying experience profound grief and loss, anger, despair, depression, and even guilt but these emotions may occur very differently among members.

What to do if someone you know is grieving:

* Reach out to the person who is grieving; don't wait for him or her to come to you. Your presence as a good listener is almost more important than anything else you can do.
* Accept the person as a living, valuable human being
* Anticipate that grief work is extremely physical as well as psychological
* Express the simple yet profound, "I'm sorry."
* Allow the grieving person quiet time
* Listen, support, encourage, and share your own feelings. Be available as someone the person can trust.
* Through your responses, give the person permission to think and feel anything
* Allow loose ends to be tied; spiritual peace, financial matters, and funeral arrangements attended to, etc.
* Help persons review their lives for meaning and purpose. This could be done with a diary, a tape recorder, drawings, scrap books, or a photo album. Remind grieving persons of their accomplishments.
* Use culturally sensitive, appropriate touch as an expression of caring. After asking permission, you may chose to hold their hand, pat their arm, give a hug
* Help persons attend to personal grooming and exercise. Take a walk with the person, listen to music together, play a game, reminisce
* Call in a spiritual consultant if the person wishes
* Use open ended communication lead-ins like: "how…, what…, where…,
- “It sounds like you're feeling…;
- share with me…,
- help me understand…"
* Recognize that persons experiencing extreme grief and loss may have sleeping, resting, and eating difficulties. Therefore, call in healthcare resources and professionals as needed.
* Tell the person that you are interested in what they think and feel. Be receptive and nonjudgmental, acknowledging the actual, potential, or perceived loss
* Recommend support groups and provide this information when appropriate
* Give the grieving person the right to cry
* Allow the person at least a full year before major life-changing decisions are made

What NOT to do when communicating with someone in grief or crisis:
* Don't assume that all questions asked demand answers. A simple, "I don't know, but tell me your feelings” is one response to the unanswerable
* Don't meet anger with anger. Allow the angry, grieving person to express the anger without becoming defensive. Acknowledge and accept the anger by saying, "You sound angry…." "It must be so difficult (frustrating) for you …"
* Don't interrupt, expound, criticize, show impatience, judge, minimize, confront, abandon, or be dishonest.
* Don't ignore the person's mental and physical pain
* Don't try to replace grief with faith
* Don't reject the person's feelings with phrases like, "cheer up…" Everything will be fine…"
* Don’t wait to be asked for help. Often the “If you need anything, call me…” is never acknowledged. Better to say, “I’m picking up some groceries, what can I get for you?” and “Today is wash day, let me do a few loads for you.” Or “I brought over the lawn mower – how do you like the grass done?”

Caring for and about someone who grieves is a great privilege.

As you face someone who is experiencing grief and loss, please believe that your efforts are valued and needed. Your presence has a profound effect on those for whom you care.

Thursday, September 4, 2008

Patient Modesty

I received an email requesting a blog on a topic which needs to be addressed more openly: Patient Modesty.

While this is a very sensitive topic many feel that it needs to be more openly addressed. In researching this subject I was very surprised, and in some cases shocked, at some stories I read on behavior that ranged from inappropriate to outright sexual misconduct. These stories came from both persons in the healthcare profession, whether it was a nurse or doctor, and patients.

To open the dialog on this subject I would like to ask two questions:

1. How would you handle a situation if a doctor or nurse acted inappropriately in your presence (as either a patient or attending nurse/physician)?

2. What would you do if a patient trusted you enough to report misconduct of a colleague of yours?

For more information on the subject, please visit the following blog:

Thursday, August 21, 2008

Your Greatest Inspiration In Becoming A Nurse

Everyone has their own story concerning what made them become a nurse. For some it's been a calling since childhood and for others it was a direct result of coming across a wonderful nurse who inspired them. Realizing that nursing is a highly stressful career, I invite everyone to remember why they became a nurse in the first place.

So, lets hear it; Why did you become a nurse? Who inspired you?

Sometimes going back to the beginning allows you to move forward.

Monday, August 18, 2008

Feeling Burned Out? Maybe Teaching the Next Generation of Heroes is Your Next Calling

I read through many posts in which current nurses are feeling burned out. A common theme among nurses is overworked, underpaid, and underappreciated. Most assuredly you are not underappreciated by your patients who are grateful for the care you provide. But, I can understand that many employers take for granted those who provide such a selfless service as nursing.
Maybe the change you need is to take your experience to the next generation of nurses by becoming a nurse educator. This would satisfy both your calling in the healthcare profession and address the shortage of nursing crisis.
I’m not certain if every state has a program to financially assist current nurses to go back to school to become nurse educators, but Pennsylvania has a fine program in place; The Pennsylvania Higher Education Foundation. Several years ago they formed to address the nursing shortage and offered scholarships, grants, and low interest loans to persons looking to become nurses. Now they find that nursing schools in Pennsylvania (and many other states) are turning away nursing candidates due to the lack of nurse educators.
If you live or work in Pennsylvania and would like to explore your options for financial aid to become a nurse educator, visit:

Tuesday, August 12, 2008

Nurses who serve those who serve


Linda S. Smith, MS, DSN, RN, CLNC

Professor and Director of the Associate Degree Registered Nurse Program at the College of Technology, Idaho State University

Last year, New Jersey born Army Captain Maria Ines Ortiz was the first army nurse to be killed in Iraq since the 2003 US invasion. She was killed during a mortar attack in Baghdad’s Green Zone. Ortiz was doing what military nurses do best – caring for the sick and wounded on or near enemy lines. She was survived by her parents, four sisters, and a fiance’. Ortiz gave her professional nursing skills and dedication, as well as her life, to serve those who so selflessly and heroically serve us.

Many of us consider great military nursing to have originated with Britain’s Florence Nightingale. It is true that the events in Scutari, Turkey gave birth to professional nursing. It is not true that Scutari was the first military location for nurses. For America, military nursing officially began with the birth of our country - the revolutionary war.

Nursing during the Revolutionary War (1776) was not recognized as a separate and distinct service. It was often included and described along with such tasks as cooking, cleaning, washing, and sewing. “Nursing” was designed to keep sick men clean, well fed, and comfortable. Camp followers on both sides of the war effort were women who washed, cleaned, cooked, and “nursed” the men. And medical care given to the wounded included purging, blistering, and bleeding. Most battle wounds were followed by uncontrolled infections, forcing surgeons to amputate. Over 90% of deaths were caused by disease – 10% by battle wounds. Wounded men would be placed side by side with men suffering typhoid and typhus, thus wiping out whole wards.

The Civil War

In 1861, President Abraham Lincoln called for volunteers to help care for sick and injured Union Soldiers. Simultaneously, women in the north began to organize relief societies. Dorthea L. Dix came to Washington, DC to volunteer her services and was immediately appointed superintendent of women nurses of the Army. (Dix had already made significant contributions to the improvement of care for the mentally ill). Dix established strict criteria for her nurses, with the idea that these women would be nursing supervisors. Her nurses were sent to Bellevue Hospital New York City, for one month of training. Clara Barton, founder of the American Red Cross, began her Civil war work in 1861 when she established an agency to distribute medical supplies to wounded soldiers.
Though enormously dedicated, hardworking, and successful, the idea of female nurses was met with opposition from male doctors and military personnel. These nurses were often outspoken about incompetence, pilfering, and corruption among army surgeons. Many hospitals had little food and even fewer supplies. Nurses wrote to their contacts and reported these terrible conditions – further angering the male physicians. They took cleanliness and organization into their own hands.
Transport services for sick and wounded men were available via railroad, steam ships and wagons, often taking days and even weeks to reach hospitals. Tents were pitched along waterways where a corp of male and female nurses worked. Religious sisters also became a vital part of the nursing staff.
Importantly, medical efforts during the Civil war led to many scientific improvements and paved the way for a new profession of nursing in the US.

Scutari and Florence Nightingale

Florence Nightingale’s best-known triumph, the organization of military nursing, took place during the Crimean War (named after Turkey’s Crimean Peninsula). In 1854, Great Britain and France declared war on Russia in order to protect Turkey from Russian attacks. Due to poor military decisions, fierce fighting and enormous numbers of causalities from wounds, cholera, and dysentery, men were dying by the thousands. Four miles of the Turkish “Barrack Hospital” housed Great Britain’s sick and dying soldiers. British people were outraged, as news of these atrocities reached England, and the Secretary of State Sidney Herbert asked his long time friend Florence Nightingale to organize a group of nurses for war service in Turkey.
Nightingale saw four miles of rat-infested corridors filled with starving, freezing men. They had no blankets, beds, or bandages. Amputations were performed without anesthetic or even the crudest sanitation. Nightingale and her 38 nurses arrived on November 5, 1854 and were given charge of 1,500 patients. In only a few months, Nightingale decreased the death rate from 42% to 2%. She transformed the Barracks into efficiently run hospitals and won the admiration and respect of the world.
Nightingale understood medical and military politics and the scientific method for gathering and reporting data. Advocating for the sick and wounded soldiers, Nightingale used her statistical and writing skills to influence increased funding and appropriations of supplies. The grateful British people donated $200,000 to her, which she used to start the Nightingale School of Nursing four years later in 1860.

Spanish American War

For the first time in US history, professionally trained nurses were accepted into military hospitals. During the Spanish American War, these contract nurses became forerunners to our present military nursing corp. The Spanish American War took place against Spain (Cuba) in 1898 and the first call for nurses came on May 7, 1898 because of the 30% sick rate among American troops. Typhoid patients would remain for hours and even days without care. Some had bedsores down to the bone. Because of the resistance to having female nurses, these health professionals knew they had to excel in every possible way. One single nurse often had to care for 40 or more delirious typhoid patients per day. Nurses worked at a frantic pace in unfurnished facilities. They also helped gather statistics and medical data related to typhoid – statistics implicating the contaminated water, food, and insects.

These trained nurses were considered by the men as angels of mercy. Thus, in December of 1898, a committee of women and nurses moved to establish a permanent Army Nurse Corp. In 1901, the Army Nurse Corp was established. In 1908 the Navy Nurse Corp (the only females in the Navy) became an important component of the US Navy. They won the praise and admiration of navel officials because, for the first time, two large nursing services were made up entirely of graduate nurses.

World War I

The US committed itself to WWI in 1917 and our Army and Navy Nurse Corp increased their numbers significantly to meet the needs of the American soldiers. Unfortunately, as our nation faced a devastating flu epidemic at home, more and more civilian nurses were leaving for military and Red Cross service. Therefore, student nurse recruitment efforts were increased.
Conditions in camp hospitals were difficult. However, World War I provided nurses with experience related to the new projectile bullets, shell fragments, poison gas, explosives, and other injury causing war machines. Nurses learned to use a weak chlorine solution for cleansing wound infections, and developed debriedment operations. Almost 300 nurses died in WW I, mostly due to disease exacerbated by overwork.

World War II

On December 7, 1941, Japanese pilots bombed Pearl Harbor and so began America’s involvement in WWII. Even before that date, however, the Nursing Council on National Defense was organized. Composed of representatives from the six American nursing organizations, this committee set out to recruit more student nurses, improve nursing education, decrease the numbers of inactive nurses, and educate and use voluntary nurses’ aides.
As with WWI, the war effort created a major civilian nursing shortage. A national plan for federal financial aid allowed schools of nursing to provide scholarships to needy student nurses and for refresher courses for inactive nurses. On July 1, 1943, a nursing student could join the Cadet Nurse Corp, receive full scholarships and a small monthly stipend. In return she had to promise to serve as a military nurse after graduation. Thus, students could complete their nursing education AND serve their country. Notably, and as a result of this national effort, nursing schools voluntarily upgraded curriculum and faculty to meet the military standards.
With the Cadet Nurse Corp and its 150,000 members, the concept of aid to nursing education became reality and civilian and military nursing collaborated. WW II also brought about the important idea of placing medical and nursing services as close to the war front as possible. The type of firepower used created more casualties but mortality was decreased because of the high medical standards and nursing services. By the end of the war, 100,000 nurses had volunteered for military service. Nurses went ashore with the invading troops and were placed where their special skills were most needed.


Today, a career as a nurse in the military means that a nurse’s educational advancement and career goals can be met through military service. Experiences in state-side military hospitals and bases, as well as overseas duty positions, are available. Reserve nursing is also available to nurses who choose this type of military service.

American military nurses continue to stand firm in their beliefs and commitments for quality, efficient health care given to our nation’s sick and wounded military personnel. Just as was the case with New Jersey born Army Captain Maria Ines Ortiz, they are proving themselves as expert, valuable, dedicated nurses – they are bravely caring for and serving those who serve us.


Austin, A. L. (1975). Wartime volunteers-1861-1865. AJN, 75(5).
Berges, F. & Berges, C. (1986). A visit to Scutari. AJN, 86(7), 811-813.
Bullough, B. (1976). The lasting impact of WWII on nursing. AJN, 76(1).
Culpepper, M. M., & Adams, P. G. (1988). Nursing in the civil war. AJN. 88(7), 981-984.
Dolan, J. A. (1966). Goodnow’s history of nursing. Philadelphia: WB Saunders Co.
Kalisch, P. A., & Kalisch, B. J. (1978). The advance of American nursing. Boston: Little, Brown, and Co.
Selavan, I.C. (1975). Nurses in American history: The revolution. AJN, 75(4).

* Portions previously published Journal of Military Nursing Research, 1(2), 12-13, 1995

Monday, August 4, 2008

Welcome Nurses To Your Blog

Welcome to the Blog Site for everyone who is in, or would like to be in, the nursing profession.

My vision here is to create a single source web-based portal for nurses to share everything from advice on their profession to how to finance continuing education. This is designed for one reason, to be YOUR resource and YOUR site.

I will be posting content from nursing professionals across the country. From there, I will circulate this blog in relative message boards in the virtual world in an effort to get maximum exposure. I would like this to be fully interactive, and welcome all those who wish to be a guest columnist to contribute.

This is your chance to have your voice heard. Whether your would like to contribute a potential posting or merely comment on an existing post, "Your Nursing Site" is here for you.

All those interested in writing a column should submit their article to:

Thank you and I look forward to hearing from you.